Lymphoedema risk

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1

Hi, I’m wondering what the current thinking is on having injections and cannula in the side lymph nodes have been removed.
I’ve had 7 nodes removed over 3 operations. I’m currently in hospital with an infection in my line. I’ve had 4 cannulas in 3 days, together with about 10 blood tests, from the one arm and hand. The veins are starting to fail. I keep being asked if they can use the other arm, and I say no, but what happens if they can’t use any veins on my good arm?

I’m quite worried as I’ve only had one chemo so far. I have port, but it has to be removed due to the infection.

Any advice welcome
Thanks

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So sorry you are in this situation . I’m a Nurse and wherever possible we do try to avoid putting lines in / taking blood / BP readings on the affected arm - usually for patients undergoing chemo or on long term antibiotics therapy we try to site either a PICC line which can last a month or a mid line cannula which is a slightly longer one Han average cannula that goes into a deeper but larger vein in the upper arm and those can last up to one week.

I’m not sure what kind of port you have had but they may not be willing to try a PICC line because of your infection. Forgive me but are the team who administer your chemo / Oncology/ BCN involved in your case ? Communication between specialities is not always that great but if you are able to contact any of them directly and explain they might be able to come up with a definite answer.

Otherwise tell the ward Nurse or the Dr. when on the ward round that this is rapidly becoming a problem / concern for you and that you want the opinion of your breast and Oncology team before they start sticking things into your operated arm .

In some circumstances for instance when we have had people with arm fractures on both sides cannulas have been sited in the dorsum of the foot . It’s also possible to take someone’s blood pressure on their leg ( often requires a different size cuff ) - if they were to use your leg for that it might help the arm that is being cannulated a bit - I would usually expect a cannula to last a bit longer than yours have so far so I’m wondering if less intervention on that arm would help the cannulas to last longer.

I personally would consider having blood drawn from my affected arm if I had to but would be more reluctant to have anything injected into it or have repeated blood pressure measurements taken. I only had one node removed though .
I hope you feel better soon . Xx

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Thank you so much Joanne. That’s really helpful.

I’m I. The oncology centre of a neighbouring hospital as mine doesn’t have overnight cover. My oncologist works at both, but notes being passed between them can be erratic.
Two of the cannulas were removed as they were put in in the a&es of each hospital, so it’s.juat the one that needed to be removed as the vein had given up.

I will talk to the nurse later about alternatives, when I have my last IV tonight (which starts at around midnight :weary:)

I had a PICC line when I had chemo 16 years ago, and had no problem with it at all. The port is in my chest. Hopefully I can see what other options there may be tomorrow.

Thanks for your help

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In my hospital we write on the cannula dressing the date they were inserted and if they aren’t tissued or inflamed would leave them up to 72 hours but they don’t all last that long .

I hope that they can get on top of it quickly for you xx

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Hi caroline_w_uk

Thank you for posting.

It sounds like a difficult time for you and it’s understandable that you are worried about having blood tests or injections in your arm on the treated side.

Developing lymphoedema after breast surgery is something that worries most women and over the years there has been conflicting evidence around lymphoedema and how to reduce the risk of this happening. Currently there is no consistent evidence of increased risk of lymphoedema associated with medical procedures (for example, blood tests, injections, intravenous medicines and blood pressure measurement) on the treated side.

With this in mind, decisions about using the arm on the treated side for medical procedures are managed on a case-by-case basis and may vary depending on the practices and protocols of treatment teams. The most recent NICE guidance (2025) indicates that a shared decision be made about using the arm on the treated side for medical procedures. Decisions are based on the person’s preference and clinical judgement, considering the individual person’s clinical need and the possibility of alternatives.

As @JoanneN indicated, we would suggest that you contact your breast care nurse or treatment team to discuss this. They will be aware of your individual situation and are in the best position to advise and guide you about how to proceed.

You may find our booklet on reducing the risk of lymphoedema a helpful read.

We also offer a range of free supportive services which you may be interested in. They include face to face and online courses and events.

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Best wishes

Eve

Breast Care Nurse

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